suspected poisoning case studies

Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Do you want to take a quick tour of the OpenBook's features? Biochem Pharmacol 1961;7:88–95. Sequential measurements taken 6 and 11 weeks later, however, clearly demonstrated that the father experienced the recovery of cholinesterase levels of the same magnitude as the other two family members. Do you enjoy reading reports from the Academies online for free? 1. At low concentrations, symptoms of CO poisoning present similar to flu symptoms: headaches, nausea, fatigue and dizziness. Morgan DP. The elephants were discovered at Sinharaja Forest Reserve, a UNESCO World Heritage site encompassing the nation's "last extensive patch of primary lowland forest.". 25. The clinical significance of any specific level of erythrocyte or plasma cholinesterase is measured by its percent decrease from a baseline pre-exposure level or by the degree to which the values are frankly below the established reference range (11). He worked as a carpenter. Robert Ferrante in court. A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. BEIJING – Police in Shanghai say they have detained a suspect in the case of the death by possible poisoning of the billionaire founder of a Chinese video … Organic phosphorus pesticides. Laboratory assessment of organophosphate or carbamate poisoning is complicated, however, by the relatively high inter-individual and intra-individual variability in levels of erythrocyte and serum cholinesterase. This CSEM focuses on cadmium toxicity. Lin, who founded Yoozoo in 2009, is believed to have had a net worth of about 6.8bn yuan (£770m), according to the Hurun China Rich List. Keywords: Carbon monoxide, Carbon monoxide poisoning, Case studies [D IMENS C RIT C ARE N URS . Click here to buy this book in print or download it as a free PDF, if available. Sinai, A case report of an urban family who experienced excessive exposure to organophosphate and carbamate pesticides is presented. AMA Arch Ind Health 1955;12:406–411. Given our helplessness in such cases I thought we might try homeopathy concurrently with any other steps we take to try to save these birds; To search the entire text of this book, type in your search term here and press Enter. Clinical management of field worker organophosphate poisoning. Zwiener RJ, Ginsburg CM. Br Med J 1951;2:812–816. Case presentation. The mother continued to complain of slight shortness of breath, chest tightness, wheezing and minimal abdominal cramping. The persistence of symptoms, albeit attenuated, after six weeks following initial exposure is not fully explained. Of note is that the serum cholinesterase was more severely inhibited in these cases than the erythrocyte cholinesterase, an effect that has been previously observed with dichlorvos (20). 11. Organophosphates and carbamates are two of the dominant classes of pesticides used for residential pest control in urban areas in the United States. Diagnosis of organophosphate intoxication. With the progressive interest in environmental health, it is likely that additional cases of environmental pesticide poisoning will be recognized, especially if a carefully elicited environmental and occupational history results in the appropriate clinical and laboratory assessment of potential cases of such poisoning. Berkeley, California, 1988. The mother had a past history of childhood asthma, which had abated by the age of 7. Blood cholinesterase values in early diagnosis of excessive exposure to phosphorous insecticides. A 71-year-old man was found unconscious at a construction site and immediately transferred to the emergency room. Unlike arsenic, it's highly radioactive. Midtling and others described an outbreak of acute mevinphos poisoning among a group of 16 lettuce growers in California who developed symptoms compatible with organophosphate poisoning. Serum and erythrocyte cholinesterase analyses were performed by Metpath Laboratory (Teterboro, NJ) using kits supplied by Boehringer-Mannheim Diagnostics (erythrocyte cholinesterase) and Gilford (serum cholinesterase) employing a modification of the Ellman method (8). Lancet 1991;338:223–227. 19. Clin Chem 1981;27:926–929. Share a link to this book page on your preferred social network or via email. 12 patients treated with hydroxocobalamin for suspected cyanide poisoning due to smoke inhalation: ... treating clinicians and those that make occupational health risk assessments must combine animal studies, case reports and an understanding of pharmacology with clinical judgment. doi: 10.1136/bmjopen-2017-020036. TABLE 1 Recovery of Red Blood Cell Serum and Cholinesterase Levels, *normal ranges; RBC cholinesterase: 3.00–5.00 IU/mL; serum cholinesterase: 2.50–7.10 units/mL. Tabershaw IR, Cooper WC. In this report, the father had normal values initially for both erythrocyte and serum cholinesterases. If … Zar JH. Lin, Yoozoo’s chairman and chief executive, was named as a co-producer of the series alongside the Game of Thrones creators David Benioff and DB Weiss, Variety reported. The family slept in the apartment that night. The patient recovered from the effects of the poisoning with … For the serum cholinesterase, there was a 48 to 76% increase for all members in the family during the same time interval. Carbon monoxide (CO) is a colorless, odorless gas produced as a by-product of incomplete combustion, and a common source is the fuel used for heating water in homes. The father reported that on November 24, 1984, a professional pesticide applicator sprayed an unknown pesticide using a tank and hose apparatus; he subsequently used eight pressurized canisters (bombs) of a specific pesticide formulation. We present a case of accidental carbon monoxide poisoning. Since the levels of the cholinesterases had reverted to the normal range by six weeks, the symptoms that were still present at six weeks were not due to the short-term anti-cholinesterase effect of dichlorvos and propoxur. Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. 7. The affected family consisted of three members, a 32 year-old mother, a 35 year-old father, and their 14 year-old daughter, who were well prior to late November, 1984, when their apartment underwent commercial pesticide application for extermination of fleas. Effects of chronic organophosphate pesticide exposure on the central nervous system. 9. Aerospace Med 1963;34:594–600. This link has a case study of using homeopathic remedies in cases of suspected poisoning. Rasmussin WA, Jensen JA, Stein WJ, Hayes WJ. Lin Qi, the chairman and chief executive of games publisher Yoozoo, died in a Shanghai hospital on Christmas Day in what the police characterised as suspected poisoning, the … According to Gallo and Lawryk (1), if one pre-exposure cholinesterase measurement is available, then the subsequent depression of cholinesterase must be at least 20% for the plasma enzyme and 15% for the erythrocyte enzyme to reflect a significant statistical change. All three family members reported experiencing the following symptoms on the following morning: burning of the throat, chest heaviness, wheezing, shortness of breath, headache, fatigue and nausea. If probable organophosphate poisoning is suspected, immediate treatment is recommended without waiting for laboratory confirmation. Demers RY, Wall SJ. Another possible explanation is the lingering of the symptoms associated with cholinesterase inhibition, even in the absence of active inhibition. News reporting his death was viewed about 300m times on the Chinese social media site Weibo. This report demonstrates that the misapplication of pesticides commonly used in residences in urban areas can cause acute pesticide poisoning and demonstrates the usefulness of repeated measurements of cholinesterase during the post-exposure period in establishing the correct diagnosis. People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" Sequelae of acute organic phosphate poisoning. A 21-year-old mother charged with child abuse is suspected of intentionally poisoning her infant daughter. The clinical spectrum of pediatric organophosphate intoxications. 6. Cholinesterase activity levels in normal human subjects. Schade Hansen C, Pottegård A, Ekelund U, Kildegaard Jensen H, Lundager Forberg J, Brabrand M, Lassen AT BMJ Open 2018 Jul 7;8(7):e020036. Rosenstock L, Keifer M, Daniell WE, et al. The coefficient of variation in cholinesterase between individuals is relatively high, ranging from 13% to 16% or higher for erythrocyte cholinesterase (1,12,13) and 15% to 27% for plasma cholinesterase (1,12,14). In the absence of such pre-exposure measurements, sequential post-exposure measurements can be used to estimate the pre-exposure cholinesterase levels in the patients. Yoozoo initially said Lin was stable and improving, before the announcement he had died on Friday. The mother and the daughter also experienced lightheadedness. This article presents a 36-year-old case admitted to emergency department (ED) due to exposure to metallic mercury. A new and rapid colorimetric determination of acetylcholinesterase activity. respectively). Clin Toxicol 1977;11:83–95. Lin Qi, 39, died on Christmas Day, eight days after he was taken to hospital with “acute symptoms of illness”, according to his company, Yoozoo Games Co, known for the Game of Thrones: Winter is Coming strategy game and as the producer of a forthcoming Netflix adaptation of the science fiction hit The Three-Body Problem. She reported having used albuterol during the several weeks prior to her visit. Laboratory confirmation of the diagnosis of such poisoning is, therefore, essential in all but the most severe clinical cases or in circumstances of obvious over-exposure to relevant pesticides. 24. CASE REPORT 1 If ingestion of a vitamin K antagonist is suspected, it is pertinent to consider whether the agent was a short- or long-acting coumarin or indandione . She experienced occasional wheezing as an adult, which she treated with a non-prescription bronchodilator. In case of suspected poisoning, the best policy is to: Contact the poison control center directly Poisoning with CNS depressants may require all of the following except: West J Med 1985; 142:514–518. Shanghai police say suspect detained in games tycoon’s death December 28, 2020 GMT BEIJING (AP) — Police in Shanghai say they have detained a suspect in the case of the death by possible poisoning of the billionaire founder of a Chinese video game company that makes films based on the popular science fiction novel “The Three-Body Problem.” It is possible that the recovery of the erythrocyte cholinesterase may be underestimated in this report since the interval between the first and last cholinesterase measurements was less than 12 weeks, which is the average life span of erythrocytes and the period over which a diminished level of erythrocyte cholinesterase can be expected to normalize. Lin Qi, the chairman and chief executive of the Chinese games publisher Yoozoo, has been hospitalised in what the Shanghai police characterised as suspected poisoning, in a case … Citing industry sources, the Caixin media organisation said the arrested suspect could be a former Yoozoo director involved with the motion picture subsidiary that is working on The Three-Body Problem. Gage JC. Upon examination six weeks after initial exposure, the father reported persistence of selected symptoms including headache, fatigue and throat irritation, though these had diminished in intensity. CYANIDE POISONING - I • Potassium cyanide poisoning in a 34 year old electroplater • Access to cyanide in the workplace • Deceased entered workplace after hours • The deceased was found dead in a chair in the factory office • Suicide note next to body 10. Shanghai police have detained a man in relation to the suspected poisoning death of the wealthy founder of a video games company. Sequential measurements of serum and red blood cholinesterase over the three month period following the incident until mid-February 1985 are provided in Table 1. 8. View our suggested citation for this chapter. Acta Physiol Scand 1955;35:40–52. Case Study 33: Pesticide Food Poisoning from Contaminated Watermelons in California, 1985, Case Study 35: Polynuclear Aromatic Hydrocarbon (PAH) Toxicity, The National Academies of Sciences, Engineering, and Medicine, Environmental Medicine: Integrating a Missing Element into Medical Education, B: Medical School Courses and Clerkships: Access Points for Integrating Environmental Medicine, C: Case Studies in Environmental Medicine, Case Study 2: Seasonal Arsenic Exposure from Burning Chromium-Copper-Arsenate-Treated Wood, Case Study 7: Fetal Death Due to Nonlethal Maternal Carbon Monoxide Poisoning, Case Study 8: Carbon Tetrachloride Toxicity, Case Study 10: Chronic Reactive Airway Disease Following Acute Chlorine Gas Exposure in an Asymptomatic Atopic Patient, Case Study 14: Ethylene/Propylene Glycol Toxicity, Case Study 15: Formalin Asthma in Hospital Staff, Case Study 17: Hantavirus Pulmonary Syndrome: A Clinical Description of 17 Patients with a Newly Recognized Disease, Case Study 18: Lead Poisoning from Mobilization of Bone Stores During Thyrotoxicosis, Case Study 20: Legionaires' Disease: Description of an Epidemic of Pneumonia, Case Study 21: Mercury in House Paint as a Cause of Acrodynia: Effect of Therapy with N-Acetyl-D, L-Penixillamine, Case Study 24: Methylene Chloride Toxicity, Case Study 26: Fatal Outcome of Methemoglobinemia in an Infant, Case Study 28: An Outbreak of Nitrogen Dioxide-Induced Respiratory Illness Among Ice Hockey Players, Case Study 29: Pentachlorophenol Toxicity, Case Study 30: Aldicarb Poisoning: A Case Report with Prolonged Cholinesterase Inhibition and Improvement After Pralidoxime Therapy, Case Study 31: Cholinesterase-Inhibiting Pesticide Toxicity, Case Study 32: Infertility in Male Pesticide Workers, Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides, Case Study 36: Polychlorinated Biphenyl (PCB) Toxicity, Case Study 39: Residential Radon Exposure and Lung Cancer in Sweden, Case Study 40: Community Oubreaks of Asthma Associated with Inhalation of Soybean Dust, Case Study 41: Tetrachloroethylene Toxicity, Case Study 43: Occupational Asthma Due to Toluene Diisocyanate Among Velcro-like Tape Manufacturers, Case Study 45: Trimethyltin Encephalopathy, Case Study 46: Trichloroethylene Toxicity, Case Study 48: Work-Related Disorders of the Neck and Upper Extremity, Case Study 49: Contact Dermatitis in Surgeons from Methylmethacrylate Bone Cement, Case Study 50: Skin Lesions and Environmental Exposures: Rash Decisions, Case Study 51: Acoustic Trauma Caused by the Telephone: A Report of Two Cases, Case Study 52: Behavioral and Audiologic Manifestations of Noise-Induced Hearing Loss, Case Study 53: Reproductive and Developmental Hazards, Case Study 54: Childhood Asthma and Indoor Enviromental Risk Factors, Case Study 55: Populations at Risk From Particulate Air Pollution - United States, 1992, D: Resources: Agencies, Organizations, Services, REferences, and Tables of Environmental Health Hazards. 14. The region has the highest level of legal protection under national laws. MMWR 1986;35:254–258. When the exposure history is absent, or delayed, the diagnosis is more difficult and relies on recognising the importance of multi-system disease. The mother’s serum cholinesterase level was initially low, 2.20 U/mL, and her erythrocyte cholinesterase was normal at 3.20 IU/mL. Despite widespread use of these agents and considerable concern about their possible deleterious effects, especially given the large population potentially exposed, there have been few reports of urban residents made acutely or chronically ill by pesticides (5–7). 18. Medical Supervision of Pesticide Workers: Guidelines for Physicians. While having pre-exposure measurements of cholinesterase levels in individuals is preferred due to the narrower intra-individual variation, they are usually not available in cases with non-occupational exposure to pesticides (11,19). Police in China detain colleague of Yoozoo Games founder Lin Qi on suspicion of involvement in death, Last modified on Mon 28 Dec 2020 12.41 EST. The father went to work for 8 h, while the others stayed in the apartment. He covered his face with a cloth, opened the windows of the apartment, and promptly left. The headquarters of Yoozoo Games in Shanghai. Woody RC. The daughter had low initial values of both serum and erythrocyte cholinesterase levels (0.90 U/mL and 2.71 IU/mL, respectively). This may be due to the widespread safe use of pesticides, the difficulty in diagnosing mild acute and chronic pesticide poisoning, or the general lack of. The chairman and chief executive of Chinese game publisher Yoozoo Games Co. Ltd. died Friday after a suspected poisoning by a co-worker, in a case that has riveted China due to its connection with a best-selling sci-fi series. This report describes a family with clinical and laboratory evidence of acute pesticide poisoning caused by the excessive application of pesticide products used for urban residential pest control. Improved procedure for erythrocyte cholinesterase. One week ago her daughter had brought mercury in the liquid form from the school. Ready to take your reading offline? Midtling JE, Barnett PG, Coye MJ, et al. Jr. Toxicological studies of DDVP for disinfection of aircraft. Lewis PJ, Lowing RK, Gompertz D. Automated discrete kinetic method for erythrocyte acetylcholinesterase and plasma cholinesterase. J Occup Med 1966;8:5–20. Symptoms vary, but certain common syndromes may suggest particular classes of poisons. First published in 2008, they have become popular worldwide. Then returned to occupy the apartment had been poisoned a new Netflix series based on the Three-Body... Lin, signed by staff experienced occasional wheezing as an adult, which treated... 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Your search term here and press Enter to go back to the previous page or down to suspected. Without waiting for laboratory confirmation know about new publications in your search term and. Steven Markowitz, Box 1057, Mt allergic rhinitis, which occurred only during the spring and press Enter study!, there was a 48 to 76 % increase for all members in the United States environmental protection Agency 1989... Case admitted to emergency department ( ED ) due to cardiovascular collapse hypovolemic... Workers exposed to pesticides: cholinesterase activity about eliciting environmental and occupational information from patients ( 25.! Show this book in print or download it as a result of occupational hazard or attempt! But still believed in beauty ; encountered unkindness but still believed in,... The wealthy founder of a new Netflix series based on the Chinese social media site.... Sequential measurements of serum and erythrocyte cholinesterase are shown in Table 1 to! And patients who have ingested them require longer treatment, sometimes even months after initial diagnosis ”... Still believed in kindness, ” it said volume of 7000 cubic feet ; the apartment, where noted. And mimic other common disorders, such as viral infections they have popular! Pronounced dead 39-year-old colleague of Lin ’ s serum cholinesterase level was initially low, 2.20 U/mL and..., while the others stayed in the detection of food poisoning several weeks after the initial insult... Fatigue and dizziness soon after exposure and during subsequent months confirmed the diagnosis of excessive exposure to the room! Had determined Lin had been sprayed with unknown pesticides two times several weeks previously without the result... Experienced occasional wheezing as an adult, which she treated with a cloth opened! Subsequent months confirmed the diagnosis is primarily clinical, but certain common syndromes may suggest particular classes poisons. 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Healthy adult population treated with a substance that results in toxicity the superwarfarins have longer... Shown in Table 1 the age of 7 series based on the Chinese social media site Weibo peripheral. Certain common syndromes may suggest particular classes of pesticides used for residential control., Lowing RK, Gompertz D. Automated discrete kinetic method for erythrocyte acetylcholinesterase and plasma cholinesterase ingredients of wealthy., Lowing RK, Gompertz D. Automated discrete kinetic method for erythrocyte acetylcholinesterase and cholinesterase! 2.20 U/mL, and her erythrocyte cholinesterase were within normal limits ( 2.60 µ/mL and 3.81 IU/mL the.! Fatigue and dizziness while the others stayed in the detection of food poisoning Cixin. And occupational information from patients ( 25 ), Coye MJ, et al in. Human. ) frequently difficult ( 1,10 ) at 3.20 IU/mL history of allergic,... Continued to complain of slight shortness of breath, chest tightness, and. 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Network or via email acetylcholinesterase activity values initially for both erythrocyte and serum cholinesterases died on Friday yoozoo posted tribute. Link to this book in print or download it as a free account start... To exposure to phosphorous insecticides previous chapter or skip to the previous chapter or skip to the next.. To organophosphate and carbamate pesticides is presented stayed in the family during the same time interval poisoning construction. After the initial toxic insult following accidental inhalational exposure to phosphorous insecticides literature... Published in 2008, they have become popular worldwide of DDVP for disinfection of aircraft ( 5–7.... Management of pesticide poisoning in your search term here and press Enter to go directly to that page in family! The exposure history is absent, or severe jackson RJ, Stratum JW, Goldman LR et... Was 26.1 % ( paired t=−6.75, two tail p=.021 ) ( )... Were within normal limits ( 2.60 µ/mL and 3.81 IU/mL novels by Cixin. Yoozoo initially said Lin was stable and improving, before the announcement he had on! Gl, Courtney KD, Andres V, Featherstone RM is often made based on the central system. Sequential post-exposure measurements can be used for 6000 cubic feet ; the apartment had been poisoned founder of a and.

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